Skip to main content
SpringerLink
Log in

Radiation dose from multidetector CT studies in children: results from the first Italian nationwide survey

  • Original Article
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Background

Multidetector CT (MDCT) scanners have contributed to the widespread use of CT in paediatric imaging. However, concerns are raised for the associated radiation exposure. Very few surveys on radiation exposure from MDCT studies in children are available.

Objective

The aim of this study was to outline the status of radiation exposure in children from MDCT practice in Italy.

Materials and methods

In this retrospective multicentre study we asked Italian radiology units with an MDCT scanner with at least 16 slices to provide dosimetric and acquisition parameters of CT examinations in three age groups (1–5, 6–10, 11–15 years) for studies of head, chest and abdomen. The dosimetric results were reported in terms of third-quartile volumetric CT dose index (CTDIvol) (mGy), size-specific dose estimate (SSDE) (mGy), dose length product (DLP) (mGy cm), and total DLP for multiphase studies. These results were compared with paediatric European and adult Italian published data. A multivariate analysis assessed the association of CTDIvol with patient characteristics and scanning modalities.

Results

We collected data from 993 MDCT examinations performed at 25 centres. For age groups 1–5 years, 6–10 years and 11–15 years, the CTDIvol, DLP and total DLP values were statistically significantly below the values observed in our analogous national survey in adults, although the difference decreased with increasing age. CTDIvol variability among centres was statistically significant (variance = 0.07; 95% confidence interval = 0.03–0.16; P < 0.001).

Conclusions

This study reviewed practice in Italian centres performing paediatric imaging with MDCT scanners. The variability of doses among centres suggests that the use of standardised CT protocols should be encouraged.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Goske MJ, Applegate KE, Boylan J et al (2008) The ‘Image Gently’ campaign: increasing CT radiation dose awareness through a national education and awareness program. Pediatr Radiol 38:265–269

  2. Tsushima Y, Taketomi-Takahashi A, Takei H et al (2010) Radiation exposure from CT examination in Japan. BMC Med Imaging 10:1–8

    Article  Google Scholar 

  3. Aroura A, Bouchud FO, Valley J-F et al (2007) Number of x-ray examinations performed on paediatric and geriatric patients compared with adult patients. Radiat Protect Dosim 123:402–408

    Article  Google Scholar 

  4. Galanski M, Nagal HD, Stamm G (2007) Pediatric CT exposure practice in the federal Republic of Germany. Results of a nationwide survey in 2005/6. Medizinishe Hochschule Hannover. http://www.mh-hannover.de/fileadmin/kliniken/diagnostische_radiologie/download/Report_German_Paed-CT-Survey_2005_06.pdf. Accessed 27 Jan 2013

  5. National Council on Radiation Protection & Measurements (NCRP) (2007) Report No. 160. Ionizing radiation exposure of the population of the United States. http://www.ncrponline.org/PDFs/2012/DAS_DDM2_Athens_4-2012.pdf. Accessed 27 Oct 2014

  6. Pearce MS, Salotti JA, Little MP et al (2012) Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet 380:499–505

    Article  PubMed Central  PubMed  Google Scholar 

  7. Mathews JD, Forsythe AV, Brady Z et al (2013) Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. Br Med J 346:f2360–2378

    Article  Google Scholar 

  8. Boone JM, Strauss KJ, Cody DD et al (2011) AAPM report No. 204: size-specific dose estimates (SSDE) in pediatric and adult body CT examinations. http://www.aapm.org/pubs/reports/rpt_204.pdf. Accessed 11 Nov 2013

  9. Teunen D (1998) European directive on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure (97/43/EURATOM). J Radiol Prot 18:133–137

    Article  CAS  PubMed  Google Scholar 

  10. European Commission (2012) Council directive laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation. http://ec.europa.eu/energy/nuclear/radiation_protection/doc/2012_com_242.pdf. Accessed 24 Oct 2013

  11. Decreto Legislativo 26 maggio 2000, n.187. Attuazione della direttiva 97/43/Euratom in materia di protezione sanitaria delle persone contro i pericoli delle radiazioni ionizzanti connesse ad esposizioni mediche (Legislative Decree n.187 of May 26, 2000. Implementation of 97/43/Euratom directive on individual health protection against ionizing radiations due to medical exposure). Gazzetta Ufficiale n.157 del 7 luglio 2000, suppl. ordinario n.105. http://people.unica.it/radioprotezione/files/2009/11/DLgs_187_26052000.pdf. Accessed 7 Oct 2014

  12. Società Italiana di Radiologia Medica (SIRM) [Italian Society of Medical Radiology], Società di Ricerca per l’Organizzazione Sanitaria (Research Society for Health Care Organization)(2010) Censimento Nazionale delle risorse umane e tecnologiche dell’area radiologica (National Survey of human and technological resources of the radiological area) Il Radiologo s2:3–39

  13. (2013) Market research CT products overview. IMV CT benchmark report. http://www.imvinfo.com/index.aspx?sec=ct&sub=dis&itemid=200061. Accessed 3 Oct 2013

  14. Bongartz G, Golding SJ, Jurik AG et al. (1998) European guidelines on quality criteria for computed tomography (EUR16262). http://w3.tue.nl/fileadmin/sbd/Documenten/Leergang/BSM/European_Guidelines_Quality_Criteria_Computed_Tomography_Eur_16252.pdf. Accessed 27 Sept 2014

  15. Palorini F, Origgi D, Granata C et al (2014) Adult exposure from MDCT including multiphase studies: first Italian nationwide survey. Eur Radiol 24:469–483

  16. Shrimpton PC, Hillier MC, Lewis MA et al (2006) National survey of doses from CT in the UK: 2003. Br J Radiol 79:968–980

    Article  CAS  PubMed  Google Scholar 

  17. Verdun FR, Gutierrez D, Vader JP et al (2008) CT radiation dose in children: a survey to establish age-based diagnostic reference levels in Switzerland. Eur Radiol 18:1980–1986

    Article  PubMed  Google Scholar 

  18. Brisse HJ, Aubert B (2009) CT exposure from pediatric MDCT: results from the 2007–2008 SFIPP/ISRN survey. J Radiol 90:207–215

    Article  CAS  PubMed  Google Scholar 

  19. Yakoumakis E, Karlatira M, Gialousis G et al (2009) Effective dose variation in pediatric computed tomography: dose reference levels in Greece. Health Phys 97:595–603

    Article  CAS  PubMed  Google Scholar 

  20. Dose Datamed 2, DDM2 (2013) Study on European population doses from medical exposure. Supplement to DDM2 project report: diagnostic reference levels (DRLs) in Europe. http://ddmed.eu/_media/news:ddm2_project_report_supplement_drls_final_draft_on_web_page_28_jan_2013.pdf. Accessed 27 Oct 2013

  21. Goske MJ, Strauss KJ, Coombs LP et al (2013) Diagnostic reference ranges for pediatric abdominal CT. Radiology 268:208–218

    Article  PubMed  Google Scholar 

  22. Kleinman PL, Strauss KJ, Zurakowski D et al (2010) Patient size measured on CT images as a function of age at a tertiary care children’s hospital. AJR Am J Roentgenol 194:1611–1619

    Article  PubMed  Google Scholar 

  23. Rizzo S, Kalra M, Schmidt B et al (2006) Comparison of angular and combined automatic tube current modulation techniques with constant tube current CT of the abdomen and pelvis. AJR Am J Roentgenol 186:673–679

    Article  PubMed  Google Scholar 

  24. Papadakis AE, Perisinakis K, Damilakis J (2008) Automatic exposure control in paediatric and adult multidetector CT examinations: a phantom study on dose reduction and image quality. Med Phys 35:4567–4576

    Article  PubMed  Google Scholar 

  25. Mulkens TH, Bellinck P, Baeyaert M et al (2005) Use of an automatic exposure control mechanism for dose optimization in multi-detector row CT examinations: clinical evaluation. Radiology 237:213–223

    Article  PubMed  Google Scholar 

  26. Sutton DG, McVey S, Gentle D et al (2014) CT chest abdomen pelvis doses in Scotland: has the DRL had its day? Br J Radiol 87:20140157

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This study was funded by the Italian Society of Medical Radiology (SIRM). We thank all the radiologists and medical physicists of the following participating Centers: Ospedale di Bressanone, Bressanone; Ospedale Sacco, Milano; Ospedale Infantile Cesare Arrigo, Alessandria; Istituto Nazionale dei Tumori, Milano; Ospedale San Giovanni di Dio, Salerno; Ospedale Maggiore di Schio-Thiene; Ospedale Santissima Annunziata, Imperia; Ospedale Policlinico Universitario, Messina; Ospedale Umberto Parini, Aosta; Istituti Ospitalieri, Cremona; Ospedale San Donato, Arezzo; Ospedale Carlo Poma, Mantova; Ospedale Niguarda, Milano; Ospedale Santa Maria della Misericordia, Perugia; Ospedale Pediatrico Meyer, Firenze; Ospedale Spirito Santo, Pescara; Ospedale Pediatrico Bambino Gesù, Città del Vaticano; Ospedale San Gerardo, Monza; Policlinico Universitario, Palermo; Ospedali Regina Margherita e Sant’Anna, Torino; Ospedale Pediatrico Burlo Garofalo, Trieste; Ospedali Riuniti Umberto I e Salesi, Ancona; Ospedale Pediatrico Giannina Gaslini, Genova

Conflicts of interest

None

Author information

Authors and Affiliations

  1. Department of Radiology, IRCCS Istituto Giannina Gaslini, Largo Gaslini, 16147, Genoa, Italy

    Claudio Granata

  2. Department of Medical Physics, Istituto Europeo di Oncologia, Milan, Italy

    Daniela Origgi & Federica Palorini

  3. Department of Sciences for Health Promotion and Mother and Child Care “G. D’Alessandro”, University of Palermo, Palermo, Italy

    Domenica Matranga

  4. Department of Medical and Forensic Biopathology and Biotechnologies, Section of Radiology, University of Palermo, Palermo, Italy

    Sergio Salerno

Authors
  1. Claudio Granata
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniela Origgi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Federica Palorini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Domenica Matranga
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sergio Salerno
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Claudio Granata.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Granata, C., Origgi, D., Palorini, F. et al. Radiation dose from multidetector CT studies in children: results from the first Italian nationwide survey. Pediatr Radiol 45, 695–705 (2015). https://doi.org/10.1007/s00247-014-3201-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-014-3201-z

Keywords

Search

Navigation